Evaluation of a phosphate management protocol to achieve optimum serum phosphate levels in hemodialysis patients.
OBJECTIVE
To evaluate the effectiveness of a protocol designed to optimize serum phosphate levels in patients undergoing regular hemodialysis (HD).


METHODS
Randomized, controlled trial.


METHODS
Hemodialysis units at Barts and the London NHS Trust and satellite units.


METHODS
Thirty-four clinically stable adults undergoing regular HD with a serum phosphate level >1.8 mmol/L on at least one occasion within 4 months of starting the study.


METHODS
Management of serum phosphate using a specially designed phosphate management protocol during a 4-month study period implemented by a renal dietitian and renal pharmacist compared with standard practice.


METHODS
Change in serum phosphate levels in both groups after 4 months.


RESULTS
Patients managed using the phosphate management protocol had a significantly greater reduction in serum phosphate levels compared with patients receiving standard practice (-0.22 +/- 0.67 mmol/L vs. +0.19 +/- 0.32 mmol/L, P = 0.03).


CONCLUSIONS
The phosphate management protocol was effective, and its implementation was associated with significantly better serum phosphate control in patients undergoing regular HD.
Yokum
Dawn
D
Department of Health and Human Sciences, Barts and the London NHS Trust, London Metropolitan University, London, UK.
Glass
Georgina
G
Cheung
Ching Fun
CF
Cunningham
John
J
Fan
Stanley
S
Madden
Angela M
AM
D002118:Calcium / Q000097:blood / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D010353:Patient Education as Topic; D010358:Patient Participation; D028044:Phosphate-Binding Proteins / Q000494:pharmacology*; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood / Q000378:metabolism
D010281:Parathyroid Hormone; D028044:Phosphate-Binding Proteins; D010710:Phosphates; D014807:Vitamin D; D002118:Calcium